Hurting for migraine relief? How to time treatment

Oct. 9, 2012
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Suzy Parker, USA TODAY

by Janice Lloyd, USA TODAY

by Janice Lloyd, USA TODAY

BOSTON - Being alert to the earliest sign of a migraine is the key to preventing it from becoming debilitating and long-lasting, a researcher said Tuesday at the American Neurological Association annual conference here.

A migraine evolves in most patients and becomes a "moving target," said Rami Burstein, a director of headache and pain research at the Beth Israel Deaconess Medical Center in Boston.

The process begins when neurons begin to respond to pain in the brain. If left unchecked, it moves onto neurons in the spine and can wreak havoc on the central nervous system. The process spirals out of control within 20 minutes to four hours of the onset of symptoms.

Best hope? Begin treatment within the first 20 minutes, he urges.

"Patients tell us there is not room inside the skull for their brains,'' said Burstein. "They feel the head is about to explode, like someone has inflated a balloon inside the head. If someone popped the balloon, they'd get relief."

But in about 65% of patients, the migraine is unrelenting and doesn't stop in the brain, he said: "The migraine can get worse. The entire body can get hypersensitive. They can't wear tight clothes, or a wedding ring, or even water from the shower feels like a pin prick."

Nearly 36 million Americans endure migraines, with three times as many women affected as men, according to the Migraine Research Foundation. While there is no cure, Burstein said, treating early can usually prevent the pain from moving to other parts of the body and stop head pain.

A family of prescription drugs called Triptans are the most commonly prescribed migraine medications, he said, and they only work on receptors in the brain where the pain begins.

So why do people wait to take medication? "People are told to bite their lip and not take medication until they absolutely need it,'' he said. "By then, it's too late."